SHOP (Small Business Health

Options Program)

Advisory Committee Meeting

June 27, 2013

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Carrier Update in Access Health CT

• Carriers that have provided non-binding letters to participate in the Connecticut Marketplace:

Individual SHOP

Aetna ------------

Anthem Blue Cross Anthem Blue Cross

Connecticare Connecticare

HealthyCT HealthyCT

------------ United Healthcare

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Carrier Update in Access Health CT continued

• Carriers have provided their plan and rate filings to the Department of Insurance.

• Access Health CT anticipates that the Carrier’s plans and rates will be known in the Marketplace by the end of July 2013. (subject to the

CT. Department of Insurance review. The Department of Insurance has final approval authority for all Carrier plan and rate filings in the State of Connecticut).

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How Will the Marketplace Affect Small Businesses?

•Starting in 2014, a SHOP will be available in the State.

•Starting October 1, plans will be available for review and enrollment for coverage starting as soon as January 1, 2014.

–Rolling monthly enrollments for employers after January 1

•Once a group is enrolled, its rate is guaranteed for 12 months.

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How Will the Marketplace Impact Small Businesses?

(cont’d.)

•To enroll, employer must:

–Have its principal place of business or an

employee worksite in a SHOP’s service area.

o Have less than 50 Full Time Equivalent /Employees.

–Have at least 1 eligible employee:

o Sole proprietors without other employees may enroll through the individual market Marketplace.

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Employer Eligibility and Enrollment Process for SHOPs

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Customer Support Services

1) An easy and simple web portal for small

businesses and brokers to shop and

compare for health insurance

2) Call center for eligibility, selection, and

enrollment assistance

3) Brokers still available for customer information and enrollment support

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The SHOP – Update #1

• The SHOP will be administered by HealthPass.

• Access Health CT will have multiple carriers and multiple

health plan options, including bronze, silver and gold plans.

• Small Businesses Owners can decide to have their

employees purchase vertically, horizontally or use a single

choice.

• Small businesses will have consolidated billing.

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The SHOP – Update #2

• Employers can decide how much to contribute toward premium costs.

• Employers can collect employee share of premiums through payroll deduction.

• Premium contributions can be made with pre-tax dollars.

• No Membership Fee will be charged to participate in the SHOP.

• Tax Credits for Small Businesses can only be obtained through the Connecticut Health Insurance Marketplace.

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Notice To Employees Of Marketplace Coverage Options

• Employers must provide the applicable Marketplace Notices to Employees of Coverage Options.

• Notices must go to all employees, regardless of their plan enrollment status or whether they are part-time or full-time by October 1, 2013.

• Model Notices are provided by the DOL.

• More information can be obtained at http://www.dol.gov/ebsa/newsroom/tr13-02.html

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Calculating the Small Business Tax Credit

• Firm Size (FTEs) = Total Full Time Employees + (Total Annual Part Time Hours/2080)

– Owners are excluded from FTE count and employer cannot receive tax credit for owner’s insurance

– All employee hours counted and based on 40 hour week

• Wages = Total Wages Paid/ FTEs

– Owner and family member wages are excluded from total wages

• Maximum Small Business Tax Credit

– Up to 50% of a small business' premium costs in 2014 for two years

– Up to 35% for tax-exempt employers (refundable via payroll tax) for two years

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Qualifying for the Small Business Tax Credit

• Contribution to health care coverage

– Do you cover at least 50% of the cost of health care coverage for your workers based on the single rate?

• Firm size

– Do you have fewer than 25 Full Time Equivalents (FTEs)

• Average annual wage

– Do you pay average annual wages below $50,000?

• Both taxable (for-profit) and tax-exempt organizations qualify

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How to Determine Tax Credit (2014)

• Credit is reduced on a sliding scale:

– As average wages increase from $25,000 to $50,000

– As FTEs increase from 10 to 25

• Connecticut Health Insurance Marketplace will make a tax credit calculator available

• National Tax Credit Calculators are publicly available:

– http://www.smallbusinessmajority.org/tax-credit-calculator/

– http://www.nfib.com/advocacy/healthcare/credit-calculator

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Four Inputs needed for Small Business Tax Credit

Analysis

• Input Information Required:

1. Full Time Employees

2. Part Time Employee Total Hours

3. Total Wages

4. Employer Portion of Total Premiums

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Small Business Tax Credit : Illustration

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Small Business Tax Credit : Illustration

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Small Business Tax Credit : Illustration

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Example of IRS form for Small Employers

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Small Business <25 Engagement

• Concerns and Considerations:

– For the small businesses that are <25 employees who don't have/won't have an agent/broker how do they get help/guidance?

– Is this group of employers a bit disenfranchised when if comes to education & support?

– As noted in the 2009 IRS report there are 53,900 businesses in the State of Connecticut that may be eligible for the Small Business Tax Credit.

– Do we expect they will simply be guided by their accountants as their "play" is mostly about the tax credit

Access Health CT

Marketing Update

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Campaign Goals

The primary mission of our campaign is to:

Build awareness of AHCT

Educate individuals and businesses how they can benefit from the AHCT

Drive enrollment

Deliver an exceptional customer experience

Foster long term favorability of AHCT

To achieve these goals, our plan utilizes an integrated approach consisting of range of tactics from both broad media use to targeted individual engagement. It is designed to produce multiple touches that build on themselves over the next 10 months.

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Strategy Development

In developing our marketing and outreach strategy, we analyzed and reviewed information in five key areas:

Strategic Consideration Marketing Action

1. Market Segmentation: • Demographic • Geographic • Attitudinal/Psychographic

Provides the under pinning for identifying and sizing key target groups, determining their location, and guiding message creation and program tactics to effectively reach and engage them

2. Distribution Channels: • Retail (e.g. IPA’s, Navigators, Brokers) • Wholesale (e.g. Hospitals, Providers) • Direct (e.g. call center, web)

Combining segment information above with distribution options available guides decisions surrounding channel use, channel needs and forecast development for channel specific enrollment

3. Messaging • Value proposition by segments • Defining unique market position for the

organization

Building on the segment research, value propositions which appeal to key groups, and underscore the unique position of the Exchange are developed: Change Benefits Enroll (all with call to action)

4. Influencers and Stakeholders

Full implementation requires a well coordinated effort among both Exchange and non-Exchange personnel. Segment understanding drives assessment and development of key partner needs.

5. Enrollment Goals Organizational enrollment objectives and targets need to be in line with marketplace experience

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Tactical Development

A deep understanding of our target consumers based research among more than 2,000 individuals and businesses in past year, guides the choice of tactics to use in our plan.

Research finding Marketing Implication

1. CT’s uninsured and underinsured residents are clustered in a handful of communities, with 80% or more of the uninsured in each county contained in 20 zip codes

Our plan will have a heavy focus on local level, grass roots community engagement in key urban areas, rather than traditional broad tactics

2. Available data sources provide robust information on key Exchange populations, allowing for precise targeting and meaningful segmentation development

We will reach out directly to our primary targets (e.g. mail, phone, canvassing, events, etc.) to build awareness and spur action, rather than utilizing more passive channels

3. Individuals have little to no understanding of how to enroll and purchase health insurance

We will offer substantial in-person enrollment support opportunities for individuals to get help rather than focusing on self service models (e.g. unassisted enrollment)

4. Skepticism and confusion abound, fostering inaction and aversion to potential messaging

More in-depth, sustained conversations need to occur to overcome these substantial obstacles, and come from trusted resources.

4. A portion of targeted individuals do not utilize and interact with traditional sales and marketing channels

CT’s diverse cultural and ethnic populations will need to be reached through civic, faith based, and service organizations who have established trust in these communities and are seen as valuable and credible resources

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Core Tactics Utilized

Campaign goals will be achieved through activity in 7 major tactical groups, as seen below. Interplay and overlap between them will be substantial, with an estimated 5 “touches” on average occurring for each individual who enrolls.

Navigator/ Assister Program

Licensed Brokers

Mass Media - PR

Call Center

Web

Exchange Field Activity

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Media Program

In order to provide a robust level of media exposure to both build awareness of Access Health CT, as well as drive enrollment, an integrated media effort utilizing 7 categories of message delivery will be deployed.

TV (broadcast and cable) Radio Print • FSI’s • Community newspapers • Ethnic Newspapers • Major dailies/weeklies

Out of Home • Bus interiors • Bus exteriors • Billboards • Door hangers • Retail posters

Digital Media • Display/Mobile • SMS

Paid Search Social Media • Facebook • Twitter • YouTube • LinkedIn

Direct Marketing (Individual and Business) • Mail • Letters • Postcards • Outbound calling

Scheduling being finalized to launch test activity in July and begin full media

presence in August, as well as increase presence in Q1.

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Field Activity Program

• In order to deliver key messages directly to our targeted populations and build awareness, generate qualified leads, and drive enrollment, AHCT will be deploying a number of high-touch, in person tactics

• Field activities will be focused on 10 key categories of activity beginning this summer

• Leads generated will be directed to use one of the 4 main enrollment channels

Activity Areas Activity Areas

1) Street Fairs and Festivals: Attendance at 46 festivals across CT during June to January time frame

6) Health Fairs: Presence at 20 Health Fairs to distribute information, but also have enrollment capabilities on site

2) Canvassing: Door to door canvassing to 120,000 households in key zip codes and dense uninsured prospect groups

7) Storefronts: Branded retail presence in 6 major metros to provide a space for both independent consumer enrollment, as well as enrollment programs for brokers, navigators and outreach workers

3) Retail Intercepts: Prospect engagement outside high traffic, targeted locations to distribute information and capture leads.

8) Tele-Town Halls: Telephone based town hall meetings promoted by local leadership, with ability to connect at any time to a customer service agent to begin shopping and enrollment process

4) Seasonal outreach: Access Health presence at CT

shoreline beaches and key fall locations 9) Partnerships: Ongoing Access Health presence at key

community partner locations such as community colleges, hospitals and libraries as well as commercial endeavors.

5) “Healthy Chat” and “Get Covered” events: Enrollment focused events occurring in community locations and coordinated with state and local leaders, as well as general advertising and promotion

10) Business Visibility: Field staff outreach to local community businesses to facilitate the placement of signs, posters, lead cards, brochures in these locations.

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Navigator and Assister Program

• The Exchange has partnered with the Office of the Healthcare Advocate (OHA) to execute its Navigator and In-Person Assister Program.

• This program will look to leverage and empower current community based resources to reach the uninsured, and offer trusted and familiar ways to get help enrolling in coverage.

• Hub and spoke system set up for Navigators and IPA’s

• Approximately 300 IPA’s will receive $5-6k grants

• Approximately 5-7 Navigator groups receiving $25-50k grants

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Broker Program

• The Exchange has fostered strong relationships with the broker sales and distribution channel in Connecticut.

• The Exchange will be partnering with brokers to execute a full broker lead and sales program containing 3 major components as detailed below. This will be in addition to providing sales support collateral for use with existing clients or to accompany their own independent efforts.

• 250 active brokers will be recruited to enroll in this program across the state, and will need to take an Exchange specific training and certification program to participate.

Listing in Public Exchange

Approved Broker Database

Participation in Broker Lead

Program

Access and Participation at

Exchange Facilitated

Enrollment Events

• Participating brokers will be listed on searchable database available on our web site, as well as utilized by our call center for broker referrals

• Qualified leads generated during both pre-open enrollment and open enrollment events will be distributed to brokers via a trackable lead management system.

• Brokers will be given access to Exchange executed events (enrollment fairs, store front activity, business expo’s) to engage and enroll clients.

1 2 3

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Enrollment Targets

The current uninsured rate in CT is approximately 9.6%. Our marketing plan is targeted to generate 100-130k net new enrollments over the course of open enrollment.

344,000 (9.6%)*

80,000

100,000

30,000^ 244,000 (7.0%)*

Total Enrollment = 100-130k

Currently Uninsured

QHP Enrollees

New Medicaid Enrollees

Remaining Uninsured

* Among a total state population of 3.5 million ^ Newly eligible Medicaid enrollee’s only. This does not include current beneficiaries who may use the system.

20,000

214,000 (4.1%)*

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QHP Enrollments by Channel

• Enrollment estimates are projected for each of the 4 major enrollment channels.

• Campaign performance and ROI will be evaluated overall, as well as by channel

• The forthcoming CRM database will be the means to conduct this analysis

Navigator/ Assister Program

Licensed Brokers

Mass Media - PR

Call Center

Web

Exchange Field Activity

45,000 enrollees

35,000 enrollees

12,000 enrollees

8,000 enrollees

CRM

Database